Long-term outcomes and prognosis for patients with sarcomatoid hepatocellular carcinoma

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Abstract

Background

Characterized by spindle cell composition in hepatocellular carcinoma tumor, sarcomatoid hepatocellular carcinoma (SHC) is a rare malignant with poor prognosis. In this study, we aimed to evaluate the clinical and pathological features of SHC and establish a nomogram that can predict long-term outcomes of the disease.

Methods

We retrospectively analyzed 63 patients who were diagnosed with SHC between October 2007 and November 2016 and used immunohistochemistry (IHC) to assessed various markers in liver samples. The clinical data and the histological and pathological findings were collected and used to build a nomogram to predict survival.

Results

The median overall survival (OS) and the recurrence-free survival (RFS) in SHC were 23.2 and 8.4 months, respectively. High expression levels of tyrosine-protein kinase Met (17/63, 27.0%) were associated with poorer RFS (P=0.040). A panel of markers, consisting heat-shock protein 70 (HSP70), glutamine synthetase (GS), and glypican-3 (GPC3), merged as an independent risk factor for treatment outcomes. The nomogram, which including this panel of markers, predicted OS times with a concordance-index (C-index) score of 0.758 (95% CI: 0.672–0.843) in the training set and 0.832 (95% CI: 0.712–0.952) in the validation set. The use of the nomogram showed marked improvements in the prediction of patient outcomes compared with conventional staging systems (P<0.05).

Conclusions

Diagnosis of SHC is rare and has a relatively poor prognosis. A panel of markers HSP70, GS and GPC3 served as an independent prognostic factor for SHC.

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Most cited references 30

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Efficacy of Larotrectinib in TRK Fusion–Positive Cancers in Adults and Children

Alexander Drilon, Theodore Laetsch, Shivaani Kummar … (2018)

Fusions involving one of three tropomyosin receptor kinases (TRK) occur in diverse cancers in children and adults. We evaluated the efficacy and safety of larotrectinib, a highly selective TRK inhibitor, in adults and children who had tumors with these fusions.

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Is Open Access

Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update

S. K. Sarin, M. Kumar, G K Lau … (2015)

Worldwide, some 240 million people have chronic hepatitis B virus (HBV), with the highest rates of infection in Africa and Asia. Our understanding of the natural history of HBV infection and the potential for therapy of the resultant disease is continuously improving. New data have become available since the previous APASL guidelines for management of HBV infection were published in 2012. The objective of this manuscript is to update the recommendations for the optimal management of chronic HBV infection. The 2015 guidelines were developed by a panel of Asian experts chosen by the APASL. The clinical practice guidelines are based on evidence from existing publications or, if evidence was unavailable, on the experts’ personal experience and opinion after deliberations. Manuscripts and abstracts of important meetings published through January 2015 have been evaluated. This guideline covers the full spectrum of care of patients infected with hepatitis B, including new terminology, natural history, screening, vaccination, counseling, diagnosis, assessment of the stage of liver disease, the indications, timing, choice and duration of single or combination of antiviral drugs, screening for HCC, management in special situations like childhood, pregnancy, coinfections, renal impairment and pre- and post-liver transplant, and policy guidelines. However, areas of uncertainty still exist, and clinicians, patients, and public health authorities must therefore continue to make choices on the basis of the evolving evidence. The final clinical practice guidelines and recommendations are presented here, along with the relevant background information.

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Overexpression of PD-L1 significantly associates with tumor aggressiveness and postoperative recurrence in human hepatocellular carcinoma.

Qiang Gao, Xiao-Ying Wang, Shuang-Jian Qiu … (2009)

The aberrant expression of programmed cell death 1 ligands 1 and 2 (PD-Ls) on tumor cells dampens antitumor immunity, resulting in tumor immune evasion. In this study, we investigated the expression of PD-Ls in human hepatocellular carcinoma (HCC) to define their prognostic significance after curative surgery. Immunohistochemistry was used to investigate PD-Ls expression as well as granzyme B+ cytotoxic and FoxP3+ regulatory T cell infiltration on tissue microarrays containing 240 randomly selected HCC patients who underwent surgery. The results were further verified in an independent cohort of 125 HCC patients. PD-Ls expression on HCC cell lines was detected by Western blot assay. Patients with higher expression of PD-L1 had a significantly poorer prognosis than patients with lower expression. Although patients with higher expression of PD-L2 also had a poorer survival, the difference in recurrence was not statistically significant. Multivariate analysis identified tumor expression of PD-L1 as an independent predictor for postoperative recurrence. No correlation was found between PD-Ls expression and granzyme B+ lymphocyte infiltration, whereas a significant positive correlation was detected between PD-Ls expression and FoxP3+ lymphocyte infiltration. In addition, tumor-infiltrating cytotoxic and regulatory T cells were also independent prognosticators for both survival and recurrence. The prognostic value of PD-L1 expression was validated in the independent data set. Our data suggest for the first time that PD-L1 status may be a new predictor of recurrence for HCC patients and provide the rationale for developing a novel therapy of targeting the PD-L1/PD-1 pathway against this fatal malignancy.

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Author and article information

Journal

Journal ID (nlm-ta): Ann Transl Med

Journal ID (iso-abbrev): Ann Transl Med

Journal ID (publisher-id): ATM

Title: Annals of Translational Medicine

Publisher: AME Publishing Company

ISSN (Print): 2305-5839

ISSN (Electronic): 2305-5847

Publication date (Print and electronic): April 2022

Publication date (Print): April 2022

Volume: 10

Issue: 7

Electronic Location Identifier: 394

Affiliations

[1 ]deptLiver Cancer Institute, Zhongshan Hospital , Fudan University , Shanghai, China;

[2 ]deptKey Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education , Fudan University , Shanghai, China;

[3 ]deptDepartment of Pathology, Zhongshan Hospital , Fudan University , Shanghai, China;

[4 ]deptInstitute of Biomedical Sciences , Fudan University , Shanghai, China;

[5 ]deptState Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences , Fudan University , Shanghai, China;

[6 ]deptDepartment of Medical Oncology, Zhongshan Hospital , Fudan University , Shanghai, China

Author notes

Contributions: (I) Conception and design: Z Wang, K Zhou; (II) Administrative support: Y Hou, F Chen, X Zhang; (III) Provision of study materials or patients: Y Ji, S Qiu, J Fan, J Zhou, Y Zhou; (IV) Collection and assembly of data: C Zhou, X Zhang, K Zhou; (V) Data analysis and interpretation: C Zhou, X Zhang; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

[#]

These authors contributed equally to this work.

Correspondence to: Zheng Wang, MD, PhD. Professor of Medicine, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200030, China. Email: wzdoc@ 123456163.com ; wang.zheng@ 123456zs-hospital.sh.cn .

Article

Publisher ID: atm-10-07-394

DOI: 10.21037/atm-21-4322

PMC ID: 9073769

PubMed ID: 35530933

SO-VID: c699d833-a219-4b29-8990-ddcfe5a25eb1

License:

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0.

Long-term outcomes and prognosis for patients with sarcomatoid hepatocellular carcinoma

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Abstract

Background

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Conclusions

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Most cited references 30

Efficacy of Larotrectinib in TRK Fusion–Positive Cancers in Adults and Children

Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update

Overexpression of PD-L1 significantly associates with tumor aggressiveness and postoperative recurrence in human hepatocellular carcinoma.

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